Five States Yet to Decide Whether to Accept Medicaid Expansion

The Affordable Care Act offers states an expansion of Medicaid (the government-run health care plan for the poor) beginning in January 2014, but opening the program up to more people would add to many states’ already over-burdened budgets. Missouri became the 24th state to pass on the expansion when the legislature failed to reach a deal before adjourning last week; 21 states will expand the program.

(The Los Angeles Times, as part of an excellent package on how the health gap may be impacted, has an infographic showing which states will expand Medicaid.)

But what of the five holdouts?

Arizona: As CQ HealthBeat reported last week, the state Senate (controlled by Republicans) voted for a proposal put forth by GOP Gov. Jan Brewer to expand Medicaid. Republicans also control the state House, but have not committed to even giving the plan a vote. The Arizona Legislature is scheduled to adjourn May 23.

Iowa: Repubican Gov. Terry E. Branstad and Democratic legislators remain divided over Medicaid expansion, one of a handful of issues keeping the legislature from adjourning. Some have floated the idea of a special session to finalize a plan. Branstad held a press conference Monday in which is discussed a potential compromise.

Indiana: The Legislature wrapped up debate on a potential Medicaid expansion by handing the decision to Republican Gov. Mike Pence, who is trying to negotiate a compromise with the federal government.

Maine: Democratic lawmakers want the Medicaid expansion. Gov. Paul R. LePage, a Republican, wants to pay off the state’s hospital debt. Last week, Democrats (who control both chambers of the legislature) pushed to combine the two plans. The Maine Legislature is scheduled to adjourn June 19.

Utah: Like Pence, Utah Republican Gov. Gary Herbert is empowered to decide whether to accept the Medicaid expansion. A meeting was scheduled for late April to weigh the options, but a decision has yet to be made.